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 Project components and activities—summary of the work plan  The current HIV population in Illinois and the Care Treatment Continuum and Surveillance Feed-back loop (Linkage to Care Work Group activities)  Share project progress, developments, challenges and successes (where we started, where we’ve come and where we are at)  Share highlights to the Routine Testing component and the Youth of Color Initiative (East Side Health District’s ) collaborative of a co-located integrated comprehensive medical, psychosocial, prevention and support services/center for LGBTY--- Kaleidoscope!

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 1. Expand routine HIV testing in 4 health systems & 7 county jails  2. Build a statewide culturally competent Disease Investigative Services network with local health departments and several “designee” agencies  3. Development of a statewide Patient Navigator program into a peer-led empowerment for HIV+ people of color  4. Statewide retention in care by increasing transportation assistance; start a texting service for appointment/medication reminders  5. Collaborate with CDPH & CDC-direct funded programs; align data systems.  6. Launch a youth of color-initiative in East St Louis to co-locate medical (including LGBT health), and other services in a single setting

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HIV Prevention and Ryan White Care Connect Regions are the same in Illinois. Each region has a lead agency and subgrantees (local health departments, CBOs, medical providers, others) delivering a variety of prevention and care services. CAPUS support makes it possible for IDPH to have a DIS designee for each region.

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34,712 persons living with HIV/AIDS in Illinois at the close of 2012 - Average # of HIV diagnoses each year = 1,825  4.7% fewer cases diagnosed in 2012 compared to 2008;  9.1% increase in the number of new cases diagnosed between 2011-2012.  Men constitute the majority of persons living with HIV/AIDS (79%); females (21%).  Current trends indicate a shift in the HIV/AIDS epidemic toward young African American MSM, including cases of co-infection with syphilis.  Overall, HIV incidence has declined sharply among IDUs and much less among high-risk heterosexuals. Source: Illinois Department of Public Health, HIV/AIDS Surveillance Unit, June 2013

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*Based on CDC report that 20% of HIV infected were unaware of their serostatus **HIV diagnoised (age 13 or older) through 12/31/2010 and living with HIV on 12/31/2011 - based on HIV surveillance data reported through 07/29/2013. ***based on the percentage of cased diagnosed in 2011 that were linked to care within 12 month of diagnosis (82%) based on the 2012 Statewide Unmet Needs Analysis that 61% of PLWLA were with needs met ƚƚBased on combined 2010 Chicago and Illinois MMP results: 88% of in care cases were on ART among which 88% with viral suppression

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 6 month planning and contract delay and hiring processes required a revised work plan, revised testing goals and project timelines  Linkage to Care workgroup continues to work through data collection/reporting with the Care Continuum for evaluation/monitoring  East Side Health Project youth center providing comprehensive services to the most vulnerable youth in Region 4  HIV Routine Testing component targeted to conduct 75,000 tests in 2014-2015  Peer Navigation training/curricula supports peer leadership development; college credit at 2 universities for the community health worker degree and endorsed by the American Public Health Association

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Illinois proposed as one of its objectives to build a culturally competent Disease Intervention Specialist (DIS)/ Linkage to Care System. Six local health departments and one community based organization have been identified across the state to serve as DIS/Linkage to Care designees outside of the County of Cook/City of Chicago. Each DIS designee will conduct an assessment of current capacity, quality and cultural competency of HIV testing, linkage to care and partner services activities for each county and region of Illinois. Relationships between the designees and the participating agencies have been established within the regions to facilitate data collection for HIV cases surveillance and supplemental surveillance actives. Memorandums of understanding (MOUs) have been sent to all LHDs and selected community based organizations. Each designee will provide training and technical assistance as needed. All participants have attended the HIV/AIDS Section “confidentiality and security training” offered by IDPH. Surveillance-based have been distributed to each region checking to make sure HIV positive individuals are in care.

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Administrative rules associated with state statues were approved to include the ability to have “designees” of IDPH for these purposes, as this state has 102 counties, and 95 certified health departments, each with local authority. Having the ability to legally establish designees was key for moving forward with identifying local/regional partners in assuring partner services/linkage to care in real time for all cases throughout the state.

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East Side Health District (ESHD) and their collaborative partners; Mallory Mahr Youth Empowerment Center, Project ARK/ The Spot, St. Clair County Health Department(SCHD), and Southern Illinois Healthcare Foundation (SIHF) have collaborated to provide medical, psychosocial, prevention and support services to Lesbian, Gay, Bisexual and Transgender (LGBT)youth between the ages of 13-24 in the East St. Louis, Illinois area.

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Obtaining executed grant agreements to officially allow for services to begin and communication to be made with all Designee partners and engaging all health departments about this new development. The infrastructure between eHARS and the Provide Enterprise system has been developed to accommodate this effort, with some experience from its initial pilot launch shortly before CAPUS support began.

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State Government lengthy hiring process and CAPUS supported positions are beginning to be filled. There has been improvement in linkage to care for newly identified HIV positive persons. However, we cannot say that those improvements are a direct result of CAPUS supported DIS/LTC activities as yet, due to the fact that cases have began to be distributed in early March, 2014.

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 East Side Health District established a clinical site – Kaleidoscope Youth Center  Each collaborative partner has committed to receive and refer clients meeting the eligibility criteria to Kaleidoscope  Mallory Mahr facilitate weekly HIV education and support groups and also offer opportunities for social interaction to Kaleidoscope clients

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 There is a need to further define division of labor between/among community partners, as some are providing some services to the same target population.  Some educational group sessions have had to be placed on hold at Kaleidoscope due to initial low program registration at youth centers

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 Grant agreements were not executed timely, therefore, program activities were delayed  Lengthy process to hire staff position within Illinois Department of Public Health